精神病学中的正电子发射断层扫描。

Psychiatric developments Pub Date : 1989-01-01
F A Wiesel
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引用次数: 0

摘要

正电子发射断层扫描使研究人脑功能成为可能。利用正电子标记示踪剂和定量模型,PET可以确定脑区域代谢和神经受体特征。精神分裂症是研究最广泛的精神疾病。大多数研究表明,大脑大部分区域的代谢率下降。有人提出,在精神分裂症患者的大脑中观察到的代谢变化是由于神经元功能的根本改变。对其他精神疾病的研究较少。双相抑郁症患者的脑代谢可能降低。强迫症和恐慌症(如果对乳酸敏感)的大脑代谢增加。这可能也是女性厌食症患者的情况。长期酗酒的酒精依赖者可能出现脑代谢下降。在一项对精神药物治疗初期精神分裂症患者的神经受体研究中,PET显示d2 -多巴胺受体增加。在另一项研究中,对照组和患者之间没有发现差异。用常规剂量的抗精神病药物治疗精神分裂症患者可使D2受体占据65%至85%,这表明精神分裂症患者不需要高剂量治疗。这些研究清楚地表明PET在精神病学研究中是一个有价值的工具。
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Positron emission tomography in psychiatry.

Positron emission tomography permits the study of human brain function. With a positron labelled tracer and a model for quantitation, regional brain metabolism and neuroreceptor characteristics can be determined with PET. Schizophrenia is the most extensively studied psychiatric disorder. Most studies have demonstrated decreased metabolic rates in wide areas of the brain. It is proposed that the metabolic changes observed in the brains of schizophrenic patients are due to a fundamental change in neuronal function. Fewer studies have been performed in other psychiatric disorders. Bipolar depressed patients probably have a decreased brain metabolism. Obsessive compulsive and panic disorders (if sensitive to lactate) have an increased brain metabolism. This is probably also the case for female anorectic patients. Alcohol dependent subjects with a long duration of abuse may have a decreased brain metabolism. Neuroreceptor studies with PET have in one study of psychotropic drug naive schizophrenic patients demonstrated an increase of D2-dopamine receptors. In another study no difference between controls and patients was found. Treatment of schizophrenic patients with conventional doses of neuroleptic drugs results in a D2 receptor occupancy of 65 to 85 per cent, suggesting that there is no need for high dose treatment in schizophrenic patients. The studies reviewed clearly demonstrate that PET is a valuable tool in psychiatric research.

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